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Durban Workshop: Improving Child Health and Nutrition in Communities

A Report to CORE Members from Larry Casazza (World Vision)

CORE was recently represented by Sanjay Sinho (CARE) and Larry Casazza (World Vision) at the IMCI workshop on "Improving Child Health and Nutrition in Communities." The landmark workshop, which took place in Durban during June 20-23, 2000, culminated months of preparation during which CORE's IMCI Working Group provided significant input at preliminary sessions and a final pre-workshop meeting at UNICEF/New York. At these sessions, the workshop's direction and focus became appropriately directed on the "how to" of bringing messages on key household behaviors to improve family health to communities and families in a sustainable way. This shift greatly enhanced the recognition of NGO input not only to the workshop, but also to the task at hand.

While the initial UNICEF invitation list was to be limited to 60 participants, more than twice that number assembled in Durban from over 20 countries----representing governments, NGO/PVOs and foundations as well as representatives from UNICEF, WHO, World Bank, bilateral agencies, and the international child health community.

Concluding Statement

At the end of three days a Concluding Statement was issued. It calls upon all partners to support families and communities through the development and expansion of the community component of IMCI and other community based health and nutrition initiatives that contribute to reducing mortality and promoting children's health, growth and development.

Key Outcomes

Participants focused their energy in these areas:

• Consensus on a core set of family care practices that are based on scientific evidence and country experience. These focus on promotion of growth and development, disease prevention, appropriate home care for illness, and care seeking behaviors. These practices can be tailored to respond to specific country situations including different health systems performance, emergencies, and responses to HIV/ AIDS.
• Agreement that community and household approaches can be effective in improving key behaviors. Experiences from both World Vision/South Africa's Bergeville and CARE/Kenya's Siaya Child Survival Projects figured heavily in discussions, and contributed significantly toward recognizing the need for establishing partnerships among communities, NGOs, civil society and other government sectors, and the private sector, which strengthen the linkages among communities, health systems, and beyond. Building on existing programs, organizational strengths and resources can lead to developing a national framework for community and household based IMCI, which is grounded in a solid understanding of the context and the determinants of behavior and interpersonal communication. Participants agreed on the need to document and share best practices and to involve youth and women as full partners with men to promote the health and development of children.
• Opportunities exist to take these approaches rapidly to scale. IMCI has been implemented in 70 countries; it must take advantage of opportunities in support of Roll Back Malaria, on-going water and sanitation and nutrition programs, and HIV/AIDS care programs.

Conclusion The Durban Workshop produced a global consensus that the community component of IMCI is essential to any improvements in child morbidity and mortality in the next decade. The challenge in overcoming the barriers of HIV/AIDS and malaria were emphasized.

CORE was represented in the post-workshop meeting to discuss the documentation of the proceedings; which will go beyond the Concluding Statement to articulate specific recommendations for each of the major partners in community based IMCI. As for CORE, its value as a network to provide a voice to the global community and to present specific, credible, and sustainable examples of community based IMCI at work was confirmed.

The spirit experienced in the February 1999 workshop, "Reaching Communities for Child Health: Partnering with PVOs in IMCI" was felt again in Durban. The task remains for CORE members to strengthen the community component of IMCI at national and district levels.

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